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Covid-19 is much more lethal in Brazil than in India and nobody knows why | India News

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NEW DELHI: Facing a surge in coronavirus infections, India is once again home to the world’s second-largest outbreak, overtaking Brazil after the latter advanced in March. But behind the grim statistical maneuvers there is an epidemiological enigma as to why the Latin American country has been much more devastated by the pathogen.
When it comes to the scale of infections, the two nations are similarly matched, with cases hovering around 14 million and hospitals from Mumbai to Sao Paulo under increasing pressure as admissions continue to rise. But it’s the divergence in deaths that has scientists baffled. Brazil, home to nearly 214 million, has seen more than 361,800 people die from Covid-19, more than double the number of deaths in India, which has a population much larger than 1.4 billion.
While deaths in India have started to rise and threaten to worsen, the disparity at the macro level persists and is emblematic of the different ways the pandemic is unfolding in all regions. Experts say this needs to be better understood and decoded to contain this global outbreak and prevent future public health crises.
Covid death rates in South Asia, including India, are consistently lower than global averages, just as those in Latin America are consistently higher, forcing virologists to offer a number of theories about why. what Covid has cut a deadliest strip from Brazil to Argentina.
“We are not comparing apples to apples here, we are comparing apples to oranges,” said Bhramar Mukherjee, chair of biostatistics at the University of Michigan School of Public Health. For now, both countries present an “intriguing puzzle: an epidemiological mystery that needs Sherlock Holmes or Miss Marple in action.”
Brazil has been hit by multiple waves that have killed an alarming number of its offspring and last week reported a record one-day increase of 4,000 Covid-19-related deaths. Meanwhile, the daily increase in casualties in India has been around 1,000 and well below last week’s. Deaths in the Asian country as a percentage of confirmed cases is 1.2 compared to 2.6 in Brazil, according to data compiled by Bloomberg.
Age variation
Multiple factors could be at play in the fatality gap, including differences in median age: 26 years in India versus 33.5 years in Brazil.
Experts have long criticized India’s broader death statistics, particularly in its rural inland areas. Before the pandemic, about one in five deaths was underreported at all, according to Mukherjee. But that doesn’t explain why Brazil’s death rate is higher than that of aging Western nations that have also been hit hard by the pandemic.
“The death rate in Brazil is even more shocking because the population is much younger than other countries, such as Europeans,” said Alberto Chebabo, vice president of the Brazilian Society for Infectious Diseases.
The increase in infection and death rates occurs when the pace of inoculation campaigns in each country has accelerated in the last month after an initially slow start. India has managed to administer more than 114 million doses of vaccines, compared with 32 million in Brazil, although the latter has injected a larger proportion of its population.
Cross immunity
Other theories behind the divergence between Brazil and India focus on the different environments and disease experiences of the two countries.
Some scientists say that widespread exposure to a variety of diseases in India may have helped its citizens develop a natural resistance against coronaviruses such as Covid-19.
Shekhar Mande, director of the Scientific and Industrial Research Council of India, is among those who have examined this trend and are co-authors of a published study on it. Their research found correlations in which citizens of countries with poor hygiene tended to cope better with Covid-19.
“Our hypothesis, and this is strictly a hypothesis, is that because our populations are continually exposed to many types of pathogens, including viruses, our immune systems do not overreact to any new variation that comes along,” Mande said. In an interview. .
Many experts acknowledge that genetics or cross-immunity could be at stake, as other South Asian countries, including Bangladesh and Pakistan, have also seen far fewer deaths than Brazil.
That 87% of Brazilians live in urban areas, but two-thirds of indigenous people live in rural places with more space and ventilation could be another reason, according to Mukherjee of the University of Michigan.
Mutant strains
Then there’s the fact that Brazil is where one of the most life-threatening coronavirus mutations, the P.1 variant, was identified in December. Together with the variants that were first seen in South Africa and the United Kingdom, studies suggest that these strains are more contagious.
“The P.1 variant has spread to many cities and states in Brazil simultaneously, which has led to a collapse of the health system, which has led to a very high mortality rate,” said Chebabo of the Brazilian Society of Infectious diseases. Brazil is in a “perfect storm,” he added, with its lack of political leadership in implementing effective measures like shutdowns, exacerbating the Covid crisis.
Mourners watch as workers in protective gear bury the coffin of a Covid-19 victim at the Vila Formosa cemetery in Sao Paulo, Brazil, on Wednesday, March 24, 2021. Brazil reported more than 3,000 deaths from Covid-19 for the first time in a 24-hour period on Tuesday, as the pandemic spreads uncontrollably through Latin America’s largest economy and the nation nears 300,000 deaths.
The rapid and sustained spread of the variant in Brazil also gave its healthcare system a respite, as opposed to a lull between waves during the final months of 2020 in India, which helped hospitals and front-line workers to recover and plan for the future.
“We are much better prepared to handle this wave than we were before in many, many ways,” Suneeta Reddy, CEO of Apollo Hospitals Enterprises Ltd., said in an interview. “We have learned the clinical protocols to treat Covid. We can use our assets and beds in a much more rigorous way. ”
India could now face the prospect of a mutant strain-driven surge that is worse than its first outbreak, though it’s hard to tell given that the Asian nation had performed genome sequencing for less than 1% of its Covid-positive samples.
Complacency, second wave
Covid mismanagement and fatigue has also been attributed to the rampant spread and rising death rates in both countries. Brazilian President Jair Bolsonaro has long opposed the closures, clashing with local governments over pandemic mitigation measures and ridiculing the use of masks.
For India, a month-long decline in daily infections from the first peak in September, coupled with the lifting of restrictions on public gatherings by officials, encouraged people to lower their guard. Many also became indifferent to the dangers of Covid after seeing friends and family with mild symptoms recover and politicians ignored security protocols.
“Brazil is a complete disaster in terms of political leadership, and India has become complacent after the initial decline in cases,” said Madhukar Pai, Canada’s research chair in epidemiology and global health at McGill University in Montreal.
It is too early to say whether India can continue to avoid Brazil’s deadliest fate. While some parts of the country have imposed selective closures, elections are underway in five states, with thousands of voters filled with campaign rallies, along with a month-long Hindu pilgrimage that brings crowds to the banks of the Ganges River.
These threaten to undo the benefits that can be derived from the intensified vaccination campaign. Daily deaths in the South Asian country have already more than doubled to more than 1,000 a day in the past week, with crematoria in many areas running non-stop and bodies piling up.
“Both countries must significantly increase their vaccination coverage and work harder to implement other public health measures,” Pai said. “What matters is that each country needs to do much more work to contain the epidemic.”

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